Individual
ANANTH ANNAMRAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1164 E HOME RD, SPRINGFIELD, OH 45503-2726
(937) 342-9260
(937) 342-9262
Mailing address
1164 E HOME RD, SUITE J, SPRINGFIELD, OH 45503-2726
(937) 342-9260
(937) 342-9262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35069365
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179776
ANTHEM BCBS
OH
01
—
0005201636
AETNA
OH
05
—
0267358
—
OH
01
—
1701283
UNITED HEALTHCARE-M & D
—
01
—
1900603
UNITED HEALTHCARE-S
—
01
—
340017944
RR MEDICARE
—
Enumeration date
11/22/2006
Last updated
01/05/2011
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